How can we prevent SARS?

1. Wash our hands often

How to wash our hands:

1. Wet hands with water
2. Work soap into a lather
3. Rub both the front and back of hands
4. Crisscross fingers from opposite hands and do "pulling" motion to reach gaps between fingers
5. Clean fingers for at least 10 seconds, including under and around fingernails
6. Rinse hands with water
7. Pour water onto the faucet to clean it before turning it off
8. Dry off hands completely with a clean handkerchief or towel

These steps will ensure that our hands are properly washed. We should especially remember to clean the faucet with water, or wrap a clean towel around the faucet, before turning it off. This will prevent our hands from being contaminated with bacteria again.

Before touching our nose or mouth, we can kill most of the bacteria by using disposable wet towels with 70% alcohol to wipe our hands.

2. Enhance our immune system

It is important to have a healthy lifestyle and diet. Eat lots of green vegetables and bean products to enhance our immune system. Our diet should consist of a variety of foods, plenty of fresh foods, and lots of fruits and vegetables.

A balanced intake of protein, vitamins, and minerals is essential. When choosing fruits and vegetables, try to select the ones that have a high content of vitamin C, vitamin E, and beta-carotene. These include kiwis, citrus fruits, broccoli, and papayas. Kiwis also contain a lot of other nutrients that help enhance our body immunity.

3. Drink lots of water

Drinking water will help enhance our excretory system and body circulation.

4. Exercise

Exercising regularly will help improve our blood circulation and body immunity.

5. Avoid long distance traveling

Don't go to the areas that the World Health Organization has determined to be infected. If you must take a long trip, plan it carefully, and take precautionary steps. Avoid going to crowded areas or hospitals, and avoid contact with animals.

- Why would frequently washing our hands protect us from SARS?
The medical community believes that SARS spread widely through hands, not by mouth. We often inadvertently touch our eyes, mouth, or nose, leaving us vulnerable to the infection of germs and bacteria. We must always be cautious, and wash our hands frequently to actively protect ourselves.

- What is the difference between wearing and not wearing a mask?
One of the main ways that bacteria spread is through droplet infection within a radius of one meter. Certified masks can block both droplets that our unaided eye can see, and ones that we cannot see. Hospital statistics show that of the medical personnel who were in contact with SARS patients, the ones who wore masks had a lower probability of virus infection than those who did not wear masks. Although masks do not offer 100% protection, they lower the probability of infection, and also prevent the spread of our own germs to other people. But we need to wear the masks correctly to ensure that they protect us.

- When should we change our masks?
Change your mask if it becomes wet, torn, dirty, or after you have been to an isolation room. People who cough need to change it more frequently. Surgical masks can usually be used for one to two days, and N95 masks for no longer than one month. For the correct length of use, please follow the instructions for your mask.

- How should we dispose of a used mask?
Use paper or a bag to wrap the used mask, then put it into a lidded garbage can. Remember to wash your hands thoroughly afterwards.

- Which kind of mask can prevent SARS?
Paper masks don't hold up to the standards for blocking bacteria. Surgical masks are made of three levels of fiber, and can better protect us from bacteria.

N95 masks can filter more than 95% of particles, and are commonly used in more dangerous environments that have higher probabilities of viral transmission. Since these masks have very tight seals that make breathing more difficult, users might often move the mask with their hands, thereby increasing the contact between their hands and face, and also the probability of bacteria infection. But regardless of which type of mask we choose, it is most important to wear it correctly.

- Under which conditions should we wear masks?
There are two reasons to wear a mask: (1) to protect you from being infected by the virus and (2) to prevent infecting others if you suspect you have the symptoms. For self protection, if you are in a crowded place or if you need to care for those who are infected, you must wear a mask. Avoid contact with other's droplets. If you suspect that you have SARS symptoms such as fever, coughing, or body aches, please wear a mask to protect others.

Please choose lint-free facial tissues. Use a tissue under the mask to add an additional layer of protection. Be sure the tissue is clean to prevent irritation, which causes coughing or sneezing and thus reduces the wear-ability of the mask.

Comparison of the Different Masks

Types	Functions
Paper Respirator	Filters droplets, does not filter viruses, one time use only
Nuisance Dust Respirator	Filters larger bacteria and heavy metal particles, does not filter viruses
Flat Particulate Respirator	Filters some viruses, does not fit as well to the face
Particulate Respirator	Filters some viruses, fits better to the face, breathes well
Medical Particulate Respirator	Filters viruses, adjustable strap
DACC Full Face Respirator	Reusable after washing, comfortable

- What is the relationship between smoking and SARS?
Diseases for the upper respiratory system and lower respiratory system are directly related to smoking. Since smoking usually involves hands touching the mouth and saliva, there is a higher chance of infection. Inhaling second hand smoke lowers the immunity of the lungs, thus also increasing the probability of infection.

- How does maintaining good air circulation help prevent the spread of SARS?
By opening the windows and allowing air to flow, the SARS virus is less likely to accumulate indoors. If you are in an air-conditioned environment, you should still open the windows if possible to allow adequate fresh air to enter, keeping the air system clean. Try to avoid entering or exiting an enclosed room, especially during meal time.

- What should we watch out for in public places?

1. Avoid sharing towels with others.
2. Cover the nose and mouth when sneezing or coughing. Always wash hands afterwards.
3. Properly dispose of used tissues (do not leave them lying around).
4. Use a face mask when in a crowded room.

- How do we disinfect our home?
To disinfect the home, use common household bleach that has been certified to kill 99.9% of bacteria on contact. Bleach and rubbing alcohol must be properly diluted in order to optimize the disinfection result. To clean your home, wipe with a mixture of 1 part household bleach with 99 part water. If an area or surface has been in contact with vomit, first rinse with water, followed by 1:49 mixture of bleach and water, rinse with water again, and finally wipe dry. (The ratio of water used may vary with different brands of bleach. Please follow the instructions as per the bleach label.)

- How do we prevent children from being infected by a family member?
Maintain good air circulation indoors. Wipe down furniture with diluted bleach daily. Soak toys daily in diluted beach for half an hour before rinsing with water. Family members should maintain personal hygiene. Wash hands after coughing, sneezing, or touching the mouth or nose, especially before physical contact with the child. Avoid kissing children on the mouth or other actions which would result in putting children in contact with your saliva or nasal fluids. If a family member has cold symptoms, have he or she wear a face mask, observe the symptoms, and keep him or her away from children.

- How do we disinfect clothes that came in contact with SARS patients?
Soak in a 1:49 mixture of bleach and water for half an hour before washing.

 

* Reviewed by: Li-Shing Wang, Deputy Superintendent of The Tzu Chi Medical Center
* Source: Tzu Chi Medical Center Infectious Disease Control Task Force, World Health Organization, Center for Disease Control, National Health Research Center, Taiwan University Public Health Research Center, Cathay Hospital Department of Infectious Disease, Hong Kong University Medical School, and News Media